17D0453334 CLIA NUMBER - RENAL CARE GROUP - LIBERAL

Laboratory Demographics

CLIA Number: 17D0453334

Facility Name: RENAL CARE GROUP - LIBERAL

Facility Address:
2319 N KANSAS AVENUE
LIBERAL, KS
ZIP 67901
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Facility Phone Number: 620 624-3950

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1346526431

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	17D0453334
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RENAL CARE GROUP - LIBERAL
Street	2319 N KANSAS AVENUE
City	LIBERAL
State	KS
ZIP	67901
Phone	620 624-3950
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024